Clinical services patient management system

ABSTRACT

A pharmacy analytics system generates clinical opportunities for patients, and the resulting opportunity file is sent to the pharmacy management system mainframe for distribution to pharmacy management systems in respective pharmacies. The clinical programs and opportunities configured in the system include immunizations, Medication Therapy Management, performance measurement, predictive refills, and the like. Opportunities for a particular patient will only be synchronized to the stores that are subscribed to by the particular patient. All clinical opportunities are sent down by the pharmacy management system mainframe to a pharmacy management system client as part of a data synchronization process or in response to a customer browse and customer select transactions. The clinical opportunities are then presented during interactions with the customer in the prescription workflow when filling prescriptions using the pharmacy management system and/or in response to a search.

TECHNICAL FIELD

This application is related to systems and methods for notifying usersof opportunities for clinical services and, more particularly, tomethods for gathering analytical data relating to clinical servicesprovided to patients by pharmacists and identifying opportunities forclinical services.

BACKGROUND

Existing pharmacy management systems generally do not provide anyfunctionality for notifying users of opportunities for clinicalservices. Instead, technicians and/or pharmacists must manually identifypotential opportunities by examining patient profiles. Additionally,there is no method for gathering analytical data relating to pharmacistsproviding patients with a service as a result of identifying suchopportunities.

Pharmacy analytics systems such as a data warehouse system provided by1010Data enable pharmacies to leverage their pharmacy data to enableinsights-based decision-making. Such systems enable pharmacies to betterunderstand how customers shop in the stores and to drive sales growth byleveraging the collected data. However, such systems do not enable thestores to track the patients' prescription data and to recommendclinical services based on such data. It is desirable to leverage suchsystems to identify clinical opportunities such as immunizations,medication therapy management (MTM), etc. at a patient level.

SUMMARY

Various details for the embodiments of the inventive subject matter areprovided in the accompanying drawings and in the detailed descriptiontext below.

The systems and methods described herein provide a technique thatleverages data from pharmacy analytics systems to identify clinicalopportunities such as immunizations, MTM, etc. at a patient level. Thecompiled data is used by the pharmacy management system to present usersof the pharmacy management system with the opportunities via a newscreen incorporated into the prescription workflow.

Queries are created in the pharmacy analytics system that generateclinical opportunities for patients, and the resulting opportunity fileis sent to a pharmacy management system mainframe for distribution tothe respective stores. In sample embodiments, the clinical opportunitiesare imported into the pharmacy management system mainframe for aplurality of pharmacy management systems, and the pharmacy managementsystem mainframe uses customer subscription tables to synchronize theopportunity files down to the respective stores. In the sampleembodiments, the clinical programs and opportunities configured in thesystem include immunizations, MTM, performance measurement, predictiverefills, and the like. Opportunities for a particular patient will onlybe synchronized to the stores that are subscribed to by the particularpatient. All clinical opportunities are sent down by the pharmacymanagement system mainframe to a pharmacy management system client forcustomers as part of the mainframe-client synchronization process. Theclinical opportunities also get pulled down by the client when a centralsearch is performed by the client through customer select and customerbrowse transactions. The clinical opportunities are then presentedduring interactions with the customer when filling prescriptions usingthe pharmacy management system and/or when concluding a prescriptionsale at a Point of Sale (POS) system in the store.

In sample embodiments, a method of providing clinical services isprovided that includes analyzing pharmacy data to generate clinicalopportunities for patients; providing files containing the clinicalopportunities to a central pharmacy management system; the centralpharmacy management system distributing clinical opportunities topharmacy management systems in respective pharmacies based on customersregistered with each respective pharmacy; and presenting clinicalopportunities for a customer during interactions with the customer in aprescription workflow when filling prescriptions using a pharmacymanagement system or when concluding a sale for a prescription at aPoint of Sale (POS) system in a pharmacy at which the customer isregistered. In the sample embodiments, the clinical opportunities mayinclude an immunization, medication therapy management, performancemeasurement, a predictive refill, and the like.

In the sample embodiments, a configuration portal may be provided thatis accessible by corporate users and editable only by business partners.The data configured using the configuration portal is saved in a centraldatabase on the mainframe and is synchronized to the client. Theconfiguration portal enables a user to add and to configure clinicalopportunities and actions associated with the generated clinicalopportunities. The configuration portal also enables the user to searchfor clinical programs including clinical opportunities based on aprogram description for the clinical programs and a designated userlevel. The configuration portal further enables the user to add a newclinical program and a user level and to specify a suppression type fora clinical program. In sample embodiments, the suppression type for aclinical program suppresses opportunities for the customer during theprescription workflow. The configuration portal further enables the userto edit at least a program description, a user level, and thesuppression type for a clinical program from a clinical program searchscreen. The configuration portal may also enable the user to create aclinical opportunity and to assign and unassign web links to a clinicalopportunity. The configuration portal may also enable the user to addand to edit clinical opportunities and to display an action associatedwith one or more clinical programs.

In further sample embodiments, the central pharmacy management systemprocesses the files containing the clinical opportunities in response touser queries to identify clinical opportunities at one or morepharmacies at which the customer is registered. The central pharmacymanagement system also periodically synchronizes new data from theprocessed files, actions taken by the pharmacy management system whenresponding to a clinical opportunity, and configuration data among thecentral pharmacy management system, the pharmacy management system, andthe POS system. The actions to be taken in response to respectiveclinical opportunities are also synchronized between the centralpharmacy management system and the one or more pharmacies at which thecustomer is registered. Also, when a patient has indicated interest inthe opportunity, an action has been taken to address the opportunity,and the pharmacist has reviewed the action taken, the clinicalopportunity is de-identified in a list of available opportunities.

In still further sample embodiments, a clinical opportunities screen isinserted into the prescription workflow when filling prescriptions usingthe pharmacy management system and a search interface is provided thatenables a user to search for available clinical opportunities and tolaunch a selected clinical opportunity to perform identified activities.A clinical opportunities screen also may be inserted into a checkout ata Point of Sale (POS) system that presents available opportunities for apatient during a checkout process. The clinical opportunities for acustomer may be presented to a clinical opportunities screen on adisplay. The clinical opportunities screen may be configurable based onpriorities of the clinical opportunities.

In other sample embodiments, a “Patient not interested” button is addedto a clinical opportunity on the clinical opportunities screen when apatient has indicated no interest in the clinical opportunity. Theclinical opportunities screen may also present a button that, uponselection, allows a user to access a clinical opportunity search screenthat produces search results from which a clinical opportunity may belaunched. Also, the clinical opportunities screen may be automaticallylaunched after a user has selected a medication using the pharmacymanagement system or when the user opens a prescription in a productreview status. A dedicated button on a medication history screen of thepharmacy management system may also be provided that launches a clinicalopportunities screen for the patient upon selection. A dedicated buttonmay also be added on an order summary screen of the pharmacy managementsystem that launches a clinical opportunities screen for the patientupon selection.

In still other sample embodiments, a clinical opportunity is suppressedduring the prescription workflow when a prescription being dispensedaddresses the clinical opportunity. Available clinical opportunities arepresented to a user of the pharmacy management system when the pharmacymanagement system is in a product review status irrespective of whetheror not the clinical opportunity already has been addressed. A clinicalopportunity at a second pharmacy where the customer is registered mayalso be suppressed when the clinical opportunity has been acted upon ina first pharmacy at which the customer is registered.

In still further sample embodiments, a list of clinical opportunitiesshown to a user of the pharmacy management system in the prescriptionworkflow is captured and a report including the list of clinicalopportunities is prepared. Also, clinical opportunities are removed fromthe central pharmacy management system as the clinical opportunitiesreach their expiration dates. A record of actions taken with respect toclinical opportunities may also be maintained.

In accordance with other aspects, the methods described herein areimplemented by a clinical services system comprising an opportunitysystem that analyzes pharmacy data to generate clinical opportunitiesfor patients and generates files containing the clinical opportunities,a central pharmacy management system that receives the files containingthe clinical opportunities and distributes clinical opportunities topharmacy management systems in respective pharmacies based on customersregistered with each respective pharmacy, and a pharmacy managementsystem in a pharmacy at which a customer is registered. The pharmacymanagement system implements a prescription workflow to fillprescriptions and presents clinical opportunities for the customerduring interactions with the customer in the prescription workflow. APoint of Sale (POS) system in the pharmacy at which the customer isregistered may also present clinical opportunities for the customer whenconcluding a sale for a prescription.

As discussed herein, the logic, commands, or instructions that implementaspects of the methods described herein may be provided in a computingsystem including any number of form factors for the computing systemsuch as desktop or notebook personal computers, mobile devices such astablets, netbooks, and smartphones, client terminals and server-hostedmachine instances, and the like. Another embodiment discussed hereinincludes the incorporation of the techniques discussed herein into otherforms, including into other forms of programmed logic, hardwareconfigurations, or specialized components or modules, including anapparatus with respective means to perform the functions of suchtechniques. The respective algorithms used to implement the functions ofsuch techniques may include a sequence of some or all of the electronicoperations described herein, or other aspects depicted in theaccompanying drawings and detailed description below. Such systems andcomputer-readable media including instructions for implementing themethods described herein also constitute sample embodiments.

This summary section is provided to introduce aspects of the inventivesubject matter in a simplified form, with further explanation of theinventive subject matter following in the text of the detaileddescription. This summary section is not intended to identify essentialor required features of the claimed subject matter, and the particularcombination and order of elements listed this summary section is notintended to provide limitation to the elements of the claimed subjectmatter. Rather, it will be understood that the following sectionprovides summarized examples of some of the embodiments described in theDetailed Description below.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings, which are not necessarily drawn to scale, like numeralsmay describe similar components in different views. The drawingsillustrate generally, by way of example, but not by way of limitation,various embodiments discussed in the present document.

FIG. 1 illustrates an overview of a clinical services patient managementsystem in a sample embodiment.

FIG. 2 illustrates a simplified flow chart of a method of presentingopportunities to a pharmacy management system in sample embodiments.

FIG. 3A illustrates a clinical opportunities search screen including abutton available in the top menu bar to allow the users to access theclinical opportunity search screen.

FIG. 3B illustrates a clinical opportunities screen that may bedisplayed during the dispensing workflow of the pharmacy managementsystem if the selected patient has available opportunities.

FIG. 4 illustrates the Medication History screen modified to include anew “View Opportunities” button.

FIG. 5 illustrates the Order Summary screen modified to include a new“View Opportunities” button.

FIG. 6 illustrates the screen for the Add Task Wizard pre-populated withdata based on the clinical opportunity when launched from a new screen.

FIG. 7 illustrates the screen for the Add Service Wizard prepopulatedwith data based on the clinical opportunity when launched from a newscreen.

FIG. 8A and FIG. 8B together illustrate the database design for thepharmacy management system mainframe in a sample embodiment.

FIG. 9 illustrates a lifecycle of an opportunity in sample embodiments.

FIG. 10 illustrates a block diagram of an example of a machine uponwhich one or more embodiments may be implemented.

DETAILED DESCRIPTION

The following description with respect to FIGS. 1-10 sufficientlyillustrates specific embodiments to enable those skilled in the art topractice them. Other embodiments may incorporate structural, logical,process, and other changes. Portions and features of some embodimentsmay be included in, or substituted for, those of other embodiments.Embodiments set forth in the claims encompass all available equivalentsof those claims. The example embodiments are presented for illustrativepurposes only and are not intended to be restrictive or limiting on thescope of the disclosure or the claims presented herein.

The functions described herein may be implemented in software in oneembodiment. The software may consist of computer executable instructionsstored on computer readable media or computer readable storage devicesuch as one or more non-transitory memories or other type ofhardware-based storage devices, either local or networked. Further, suchfunctions correspond to modules, which may be software, hardware,firmware, or any combination thereof. Multiple functions may beperformed in one or more modules as desired, and the embodimentsdescribed are merely examples. The software may be executed on a digitalsignal processor, ASIC, microprocessor, or other type of processoroperating on a computer system, such as a personal computer, server, orother computer system, turning such computer system into a specificallyprogrammed machine.

Terms and Definitions

Automated Courtesy Refill (ACR): ACR is an opportunity under the program‘Predictive Refill.’

Data Warehouse: A large store of data accumulated from a wide range ofsources within a company and used to guide management decisions.

GCSN: Generic Code Sequence Number is a unique number that groups drugsinto categories such as active ingredients, strength, route ofadministration, and dosage.

ILE: The initial load extract process is performed when opening a newstore or performing a store start-over in the event of complete hardwarefailure. The ILE is responsible for pulling data from the mainframe topopulate local database tables. For example, the ILE process may need tobe updated to pull static data such as program and opportunitydefinitions, configurations, etc. as well as the patient levelopportunities and associated action data.

MTM: Medication Therapy Management is a service provided by a pharmacistto their patients which assists in ensuring proper therapeutic treatmentand aims to increase overall medication adherence by patients andaddress gaps in therapy.

NexGen: A Pharmacy Management Application implemented by Rite AidCorporation as a prescription order fulfillment and customernotification system.

Opportunity: An opportunity is a system defined set of circumstances forproviding various clinical services that a patient has met. For example,the opportunity may address a gap in the patient's medical care. Sampleopportunities include a Pneumovax 23 (65+) vaccine, a Statin-RedStar-Adherence consultation, a prescription refill, and the like.

Opportunity System: A data warehouse analytics solution provided bypharmacy analytics vendors.

OTR: One Trip Refills is a refill program that allows enrolled patientsto have all of their prescriptions picked up on the same date.

Portal: A website that provides access to a wide array of web basedapplications for both store and/or corporate users.

Program: A program is a high-level area of focus for which to identifyand present patient opportunities. Examples of a program include, butare not limited to, immunization, MTM, predictive refill and performancemeasurement.

SQL: Structured Query Language is a database query language used toobtain and/or manipulate data in a database.

Process Overview

Queries are created in the pharmacy analytics system that generateclinical opportunities for patients, and the resulting opportunity filesare sent to the pharmacy management system mainframe for distribution tothe pharmacy management systems in respective stores. In sampleembodiments, the clinical opportunities are imported into a pharmacymanagement system mainframe, and the pharmacy management systemmainframe uses customer subscription tables to synchronize theopportunity files down to the respective stores using a datasynchronization process. In the sample embodiments, the clinicalprograms and opportunities configured in the system includeimmunizations (e.g., flu shots), MTM (e.g., Outcomes, performancemeasurement (e.g., Red Star Adherence Consultation), predictive refills(e.g., One Trip Refills (OTR) and Automated Courtesy Refills (ACR)), andthe like. Opportunities for a particular patient will only besynchronized to the stores that are subscribed to by the particularpatient. All clinical opportunities are sent down by the pharmacymanagement system mainframe to a pharmacy management system client forcustomers as part of a mainframe-client synchronization process. Theopportunities may also get pulled down when a central search isperformed by the client through the customer select and customer browsetransactions. The clinical opportunities are then presented duringinteractions with the customer in the prescription workflow when fillingprescriptions using the pharmacy management system and/or whenconcluding a sale at a Point of Sale (POS) system in the store.

System Overview

FIG. 1 illustrates an overview of a clinical services patient managementsystem 100 in a sample embodiment. As illustrated, the store housing thepharmacy 110 includes a pharmacy management system 112 that thepharmacist uses to fill prescriptions. The pharmacy 110 also includes apoint of sale (POS) system 114 including one or more point of saleregisters that may be used to complete the sale when the customerarrives to pick up a prescription. In sample embodiments, customers mayinteract with the pharmacy system 112 via the Internet 120 using one ormore customer devices 130, 132 to electronically submit prescriptions tobe filled and to receive notifications when the prescriptions are ready.

In sample embodiments, the clinical services patient management system100 includes a pharmacy management system mainframe (or central)computer 140 that interacts with a pharmacy data analytics/opportunitysystem 150 that generates clinical opportunities as described herein.The pharmacy data is stored in a data warehouse/database 160 (e.g., SQLdatabase) along with relevant store, customer, and prescriptioninformation. The mainframe computer 140 also includes a database 165that stores data for the respective pharmacies, as described below. Theuser 170 may interact with the pharmacy data analytics/opportunitysystem 150 to submit queries to the pharmacy data stored in the datawarehouse to 160 identify the opportunities described herein. A portalsystem 180 also enables the user 190 to add and to configure programsand opportunities for implementation by the pharmacy dataanalytics/opportunity system 150 to generate the opportunities describedherein and to add/modify the actions associated with the generatedopportunities.

In sample embodiments, the pharmacy management system 112 implements theNexGen Pharmacy Management Application implemented by Rite AidCorporation as a prescription order fulfillment and customernotification system. The pharmacy management system 112 provides adispensing flow to the pharmacist. Also, as described below, thepharmacy management system 112 is modified to enable the pharmacistand/or technician to search for and respond to clinical opportunitiesfor patients. As also described below, the POS system 114 may alsoprovide the salesclerk with access to the clinical opportunities via aninterface of the POS system 114 and to print point of care (POC)paperwork as needed.

In sample embodiments, the pharmacy data analytics/opportunity system150 is a data warehouse system provided by 1010Data that evaluatespharmacy data in data warehouse/database 160 to identify opportunitiesand to report the same to the user 170 in response to a search and tothe mainframe 140 for distribution to the respective pharmacies 110. Themainframe 140 processes the data received from the pharmacy dataanalytics/opportunity system 150 and sends responses to the pharmacydata analytics/opportunity system 150 in response to queries asappropriate. Also, the mainframe 140 synchronizes new data, actionstaken by the pharmacy management system 112, and configuration databetween the mainframe and the respective pharmacy management systems 112and POS system 114 in different pharmacies 110. The pharmacy data isretained in tables in the database 165 and provided to the respectivepharmacy management systems 112 and POS systems 114 at selected storesthrough the data synchronization process via the Wide Area Network 195.In this fashion, the mainframe 140 manages the implementation ofopportunities identified by the clinical services patient managementsystem 100.

During operation, the clinical services management system 100 identifiesclinical opportunities for patients/customers by analyzing/querying thepharmacy data stored in database 160 using the pharmacy dataanalytics/opportunity system 150. The pharmacy data is stored in themainframe database 165 and the data required for analytics is pushedfrom the mainframe database 165 to the data warehouse 160. Theidentified new opportunities are provided to the database 165 of themainframe 140 periodically (e.g., daily) using, for example, FileTransfer Protocol (FTP), and then provided to the pharmacy managementsystems 112 and POS system 114 of respective pharmacies 110 duringperiodic (e.g., every thirty minutes to one hour, with most of the dataprocessing completed before the store opens) synchronization processesbetween the mainframe 140 and the pharmacy management systems 112 andPOS system 114 of the respective pharmacies 110. As appropriate,customer inputs for opportunities are fed into the pharmacy managementsystems 112 by technicians or pharmacists. The actions taken in responseto the identified opportunities are also synchronized to thecorresponding pharmacies 110 for each customer. The opportunities aremarked as pending until completed. Completed opportunities are also sentback to the mainframe 140 and to the pharmacy data analytics/opportunitysystem 150 to indicate that an opportunity has been completed.

Opportunity System 150

The pharmacy data analytics/opportunity system 150 receives andidentifies clinical opportunities for patients based on availableclinical programs. In sample embodiments, a large scale code based datamanagement system for data warehousing such as a data warehouse systemprovided by 1010Data may be used as the data warehouse 160 and theassociated pharmacy data analytics system 150 may implement theopportunity system described herein. The 1010Data system populatesqueries written to generate opportunities. Such a system enables usersto submit queries to their pharmacy data stored in the data warehouse160 to identify the clinical opportunities described herein. In such assystem, the pharmacy data analytics/opportunity system 150 may executequeries regularly to target customers/patients for clinicalopportunities. The opportunity system 150 may perform a full refresh ofthe configuration elements daily. In response to the queries, the datawarehouse 160 creates a feed to the pharmacy management system mainframe140 with opportunities for the registered customers at the respectivepharmacies. The opportunities may be separated by store and include thefollowing data elements:

-   -   Opportunity ID    -   Customer number    -   Date (optional)

All actions taken in response to opportunities from the pharmacymanagement system 112 are processed and fed back to the pharmacy dataanalytics/opportunity system. The pharmacy data analytics/opportunitysystem 150 appends all opportunity and action activity from the pharmacymanagement systems 112. Only the latest status for the opportunity andaction from the pharmacy management systems 112 need to be stored. Theresponses from the pharmacy management systems 112 are processed beforethe queries can run to identify new opportunities. Once the opportunityis closed, the record will remain in the opportunity system 150 forfuture reference or reporting but is not sent again to the customer.Multiple versions of the same opportunity and customer could exist andare differentiated by the creation date of the opportunity. Outcomesdata may be incorporated into the opportunity system 150 at the pharmacymanagement system mainframe 140. Customer merges may generateopportunities for the new customer record. For example, claims data froman external vendor may provide MTM opportunities.

The processing of data by the opportunity system 150 to update thepharmacy management system mainframe 140 follows a number of rules. Forexample, there is a configuration value that controls how many recordsare processed during the pharmacy management system mainframe 140processing of opportunity system 150 records for each daily run.Regardless of the opportunity status on the pharmacy management systemmainframe 140, if an opportunity sent from the opportunity system 150search already exists on the pharmacy management system mainframe 140,then that record is not replaced. If an opportunity sent from theopportunity system 150 search does not already exist on the pharmacymanagement system mainframe 140, then the opportunity is inserted with aNew (N) status with the creation date as the current date. If a Pendingopportunity is omitted from the opportunity system 150, a soft delete isperformed by marking the record as Deleted (D) for the opportunitysystem 150 to pick up that night. If a Deleted opportunity is omittedagain, a physical delete is performed. If a New opportunity is omittedfrom the opportunity system 150, a soft delete is performed by markingthe record as Removed (R) for the opportunity system 150 to pick up thatnight. If a Removed opportunity is omitted again, a physical delete frommemory is performed. If a Closed (C) opportunity is omitted from theopportunity system 150, a physical delete from memory is performed.

The data used for generating the global patient opportunity list residesin the opportunity system data warehouse 160. Once compiled, theopportunities from the opportunity system 150 are sent to the database165 of the pharmacy management system mainframe 140 and thensynchronized to the servers of the respective stores' pharmacymanagement system 112 for all patients subscribed to a store. Thepharmacy management system mainframe 140 provides selected opportunitiesfor customers at the respective stores to which the customers areregistered. New opportunities are compared to the opportunities storedin the pharmacy management system mainframe 140 and the storage tablesfor the opportunities are updated as appropriate. Similarly, the tablesidentifying the registered customers and the pharmacies that are part ofthe system are updated as appropriate based on update configuration dataprovided by the portal system 180. This updated data is then pushed tothe respective pharmacies 110 during the synchronization process.

Customer Devices

The clinical services patient management system 100 described herein maybe adapted to work with the customer's communication devices 130, 132such as smart phones, laptops, personal computers, and the like withoutrequiring the customer to download specific software or to have anaccount with the pharmacy. The customer's communication devices 130, 132may be used to collect customer information, to authenticate thecustomer, to collect payment information, to authorize prescriptionpickup or delivery, etc. All that is required is Internet access to aweb interface provided by the clinical services patient managementsystem 100.

Pharmacy Management System 112

The pharmacy management system 112 functions in the conventionalfashion. A pharmacy management system 112 such as the NexGen PharmacyManagement Application implemented by Rite Aid Corporation provides asystem for prescription order fulfillment and customer notification. Thepharmacy management system 112 provides a dispensing flow to thepharmacist. In a sample configuration, the dispensing flow includes:

1. Searching and selecting a patient for dispensing a prescription.

2. Scanning a prescription image for non-electronic or writtenprescriptions.

3. Searching and selecting a prescriber for dispensing the prescription.

4. Search and selecting the medication for dispensing the prescription.

5. Entering dispensing details.

6. Selecting a payment method and adjudication, which may includeediting the customer's insurance data.

7. Reviewing the prescription data.

8. Performing drug utilization review.

9. Performing final product review.

Upon completion of the final product review, the prescription goes toWill Call. In sample embodiments described herein, a ClinicalOpportunities screen is inserted into the prescription workflow topresent available opportunities for a patient to the pharmacist duringthe process of filling the prescription. The Clinical Opportunitiesscreen generally makes the pharmacist aware of the programs and clinicalopportunities for which the patient may qualify. A search interfaceenables the pharmacist/technician to search the available opportunitiesand to launch a selected opportunity to perform the identifiedactivities (e.g. administer a vaccine).Point of Sale System 114

The point of sale (POS) system 114 completes the sale of theprescription to the customer. In sample embodiments, applications of thepoint of sale system 114 interface with the pharmacy system 112. Forexample, the point of sale system 114 supports the GetRxInfo service.GetRxInfo is a webservice called by a POS application of the POS system114 when a prescription is scanned at the POS system 114 during a sale.The GetRxInfo service returns the data needed by the POS application ofthe POS system 114 to sell the prescription. Examples of the data neededby the POS application of the POS system 114 include the customer's dateof birth, whether the customer's ID needs to be collected before thescript can be sold, etc. The POS application of the POS system 114 callsthe GetRxInfo webservice by passing the location, prescription (Rx)number, and date of service for the script that is to be sold. The queryparameters are passed to the GetRxInfo service in a query string of theURL.

The response from the GetRxInfo service will be either a success messagealong with the data needed to sell the prescription or an error messageif the prescription is not in a state to be sold. A successful responsewill be sent back to the client if the prescription is in will callstatus and POS data is available in the pharmacy management system 112.However, an error response may be sent back in following cases: theprescription is not found in the pharmacy management system 112, theprescription is found in the pharmacy management system 112 but is notin will call status, or the prescription is in will call status but POSdata is not available in the pharmacy management system 112. The errorresponse may include any or all of the following data elements: versionnumber for the service, prescription location, prescription number, dateof service, pharmacy system order number for the prescription, pharmacysystem order item number for the prescription, response status, anderror message. If the message is a success message, the success messagemay further include the pharmacy system customer number, customer nameand birth date, customer pay amount for the prescription, whether taxhas to be collected from the customer for the prescription and, if so,the amount of the tax. The success message also may identify if thepayment is by cash, by commercial insurance plan, or by governmentbacked insurance plan. If by insurance plan, the success message mayalso identify the insurance agency, plan and group.

The success message may also contain certain POS flags including, forexample, the drug being dispensed and a prompt for a customer HIPAAacknowledgement message and customer authorization request for customerenrollment in certain programs at the POS system 114. The flags may alsoidentify if the customer is in a certain program such as a seniorprogram or a prescription refill program.

In sample embodiments, the POS system 114 displays certainprescription-level (e.g., prescription in progress/Will Call) andpatient-level (e.g., Check Photo ID) notifications when prescriptionsare scanned at the POS register 114. The notification text and displayorder of the different notifications are typically hard-coded into theapplication. Clicking/touching the notification text opens a detailedview containing multiple grids titled “Will Call/Work in Progress”,“Consultations”, “AOB Documents”, and “Additional Information”.

To implement the functionality described herein, a new notification isadded that informs users that the patient for a scanned prescriptionqualifies for clinical opportunities as described herein. Uponclicking/touching the notification text, the detailed view shouldcontain only two grids: “Script Notifications” and “PatientNotifications”. The “Patient Notifications” grid should contain allpatient-level notifications. Also, the notification text allows users torespond with a “Patient not interested” action for any clinicalopportunities that are displayed and in closed status.

Notifications of clinical opportunities are displayed when the patienthas any clinical opportunity present (regardless of opportunity status)where the action “Patient unavailable” has previously been selected by auser (technician or pharmacist) of the pharmacy management system 112,or the patient has a clinical opportunity present that is configured tobe displayed in the POS system 114. When an opportunity has thisconfiguration set, the opportunity notification will be displayedregardless of any actions taken, even if the opportunity is closed. Thepriority of the notification on the display is configurable. For eachclinical opportunity that is displayed, if the program in which theopportunity belongs to is configured to have the “Patient notinterested” action and the opportunity is in a Closed status, then theuser will have the option to choose “Patient not interested” from thePOS system 114. This will result in the same action being recorded aswhen “Patient not interested” is chosen from within the pharmacymanagement system 112.

In sample embodiments, when the user clicks on the “Patient notinterested” button, the button will remain disabled while processing. Ifthe “Patient not interested” action is successfully added to theopportunity, the button will remain disabled with the text “[DONE]”appended to it. If the “Patient not interested” action is notsuccessfully added, then the button will become re-enabled.

A new configuration value may be available at the opportunity-levelwhich, when set, will cause the POS system 114 to display a notificationwhenever the configured opportunity is present for a patient of ascanned prescription at the POS system 114. This notification will bedisplayed regardless of any action taken on the opportunity or lackthereof, even if the opportunity is closed.

Also, while the pharmacy management system 112 may provide manydifferent actions for a technician/pharmacist to choose from whenresponding to an opportunity, the POS system 114 may only provide a“Patient not interested” option. If the patient is interested and aphysical action is taken in the pharmacy management system 112, such ascreating a prescription, enrolling in a refill service, etc., then theopportunity for the patient is de-identified in the next daily feed ofavailable opportunities by the opportunity system 150. Under normalrequirements of the pharmacy management system 112, once an opportunitybecomes closed, it is omitted from the following day's feed ofopportunities and will be physically deleted from the pharmacymanagement system mainframe 140. Once this occurs, then the data wouldnot be available to be displayed on the POS system 114. In order foropportunities that are closed to be displayed on the POS system 114outside of the same day, the queries of the opportunity system 250 mayhave logic to keep sending these opportunities (e.g. a query may decideto re-send a closed opportunity if the only action chosen was “Patientunavailable”—then the POA system will still see and display theopportunity).

Configuration Portal 180

The configuration portal 180 provides the capability to setup and tomanage the configurations of programs and opportunities through a simpleinterface. For example, the configuration portal 180 provides a user 190with the capability to search for programs currently defined. The user190 will be able to search based on the program description for userlevels defined for the user level for pharmacists (opportunities willonly be displayed to a pharmacist) or the user level defined for allusers (opportunities will be displayed to all users). The search mayalso be based on the suppression type. The search results will displayprograms that match the search criteria or all programs if no searchcriteria were used. For each program, the following fields may bedisplayed:

Program Id

Program Description

User Level

Suppression Type

Last User ID

Last Updated Date

The configuration portal 180 may also provide a user with the capabilityto add a new program. To add a user level, the user provides a programdescription, a user level (e.g., pharmacist or all users), andsuppression type. The suppression type at a program level allows theuser to suppress opportunities for a customer during the dispensingflow. The values are populated based on the configuration selection.

The configuration portal 180 may also provide the capability for a userto edit an existing program. From the program search screen, the userselects an existing program for update. This will take the user to theprogram setup screen where the fields will be displayed for update. Theuser may edit the program description, the user level, and thesuppression type. The values again are populated based on theconfiguration selection. If an existing suppression value is removed, awarning will be displayed and the underlying values will be cleared fromthe table.

The configuration portal 180 also permits actions to be assigned orunassigned to a program. A minimum of one assigned action is required ora warning will be displayed. All available actions may be displayed witha checkbox on the left to indicate whether an action has been assignedor unassigned for a program. To add a new action, a blank Action SetupScreen may be launched.

The configuration portal 180 also enables web links to be assigned orunassigned to a program. All available web links may be displayed with acheckbox on the left to indicate whether a web link has been assigned orunassigned for a program.

The configuration portal 180 further enables the user to addopportunities for an existing program. An add icon allows the user toadd an opportunity by launching the Opportunity Setup Screen. The fieldsavailable for user entry include the Opportunity Description, Priority(e.g., value 1-99), and Suppression Value(s). The suppression values atan opportunity level allow the user to suppress opportunities for acustomer during the dispensing flow. The values are populated based onthe configuration selection.

All available configurations are displayed to the user. The user alsomay remove a configuration. The portal application 180 need not enforceany business rules as it relates to actions assigned to a program towhich an opportunity belongs. The following fields can be added toconfigure an opportunity for a program:

Config Name/Type—values are populated based on the configurationselection, including Add Start by Date, Task Priority, Add Service Type,and Add Service Vaccine.

Config Value—values are populated based on the configuration selection.

The configuration portal 180 may further provide the capability to editopportunities for an existing program. An edit icon allow the user toedit the opportunity by launching the Opportunity Setup Screen for theselected row. The parameters that may be edited include the OpportunityDescription, Priority (e.g., values 1-99), and Suppression Value(s). Thelist is based on the program type selected, and multiple values may beselected.

The configuration portal 180 also provides the capability for a user todisplay existing actions. For each action, the Action Code and ActionDescription are displayed.

The configuration portal 180 further provides the capability to addactions outside the program flow. The fields available for user entryinclude the Action Description and the Action Code. The user may enteran action ID when adding a new action, but the action ID cannot be aduplicate of an existing action ID. The action ID may be used forsorting in the pharmacy management system 112.

Finally, the configuration portal 180 may also provide the capabilityfor a user 190 to edit actions outside the program flow. However, theactions can only be unassociated from programs. The parameters that maybe modified include the Action Description and the Action Code.

System Flow Chart

FIG. 2 illustrates a simplified flow chart of a method 200 of presentingopportunities to a pharmacy management system 112 in sample embodiments.As illustrated, the method includes analyzing pharmacy data to generateclinical opportunities for patients at operation 210, and providingfiles containing the clinical opportunities to a central pharmacymanagement system 140 at 220. The central pharmacy management system 140distributes the clinical opportunities to pharmacy management systems112 in respective pharmacies based on customers registered with eachrespective pharmacy. The clinical opportunities for a customer arepresented during interactions with the customer in a prescriptionworkflow when a pharmacist fills prescriptions using pharmacy managementsystem 112 or a salesclerk or technician concludes a sale for aprescription at a Point of Sale (POS) system 114 in a pharmacy 110 atwhich the customer is registered. As noted above, in sample embodiments,the clinical opportunities may include an immunization, medicationtherapy management, performance measurement, predictive refill, and thelike. Further details regarding the operation of the respectivecomponents are provided in the sample embodiments described with respectto FIG. 3 to FIG. 9 .

Sample Embodiments

The system configures clinical programs and clinical opportunities thatare to be presented for each patient. The data elements for the clinicalprograms may include the program ID, the program description, and userlevel values indicating whether the opportunities will only be displayedto a pharmacist or will be displayed to all users. The data elements forthe clinical programs also may include suppression type values such asvaccine, service, national drug code (NDC), and GCSN, which aredescribed in more detail below. On the other hand, the data elements forthe clinical opportunities may include the opportunity ID, theopportunity description, priority, program ID, and suppression value.Configurable elements for the clinical opportunities may include, forexample, Add Task Screen, Print Forms Screen, and Add Service Screen.Add Task Screen includes a “start by” date for a generated task (# ofdays from current time) and a default of zero (current time), as well asa “priority” for a generated task (High/Medium/Low). The defaultpriority is high. The service (e.g. “vaccine” field) may be pre-selectedon the Add Service Screen when launched via actions.

In sample embodiments, a new screen is created within the pharmacymanagement system to display and to take action on availableopportunities. The patient related data elements listed below aredisplayed at the top of this screen. These data elements also may beshared with the Medication History screen in the pharmacy managementsystem:

Name

Address

Phone

Date of Birth

Gender

Compliance/Adherence Score (if available)

OTR Contact Number (if available)

OTR 1st Target Date (if available)

OTR 2nd Target Date (if available)

A list of currently available opportunities for a patient will bedisplayed based on priority. The number of opportunities to be displayedat a time is configurable. For each opportunity, the following dataelements may be displayed:

Program Name

Opportunity Description

User Action Taken Flag

Last User to Take Action

Time of Last User Action Taken

Etc.

All available actions for the selected opportunity may be displayed. Thelist of actions will for each program is predefined. For each action,the following data elements may be displayed:

“Perform Action”! “Undo Action” image button

Action Description

Last User to Take Action

Time of Last User Action Taken

The clinical opportunities screen may also contain a section for theuser to enter comments. Comments entered will be specific to eachopportunity rather than tied to a single action. Only one set ofcomments are kept for each opportunity, meaning that a second userviewing the opportunity will see the first user's comments and anychanges to the comments by the second user will update or overwritecomments made by the first user.

Portal links also may be available on the clinical opportunities screenfor all opportunities and can be configured at a program level. If noopportunities are configured for the current program(s), then the“portal links” button will not be displayed. Sample portal linksinclude:

State Immunization Registry (where applicable)

Vaccine Central (results from external source)

Outcomes MTM

EQuIPP (pharmacy benchmark performance tool)

The pharmacy management system may be modified to create a new screen toallow the user to search clinical opportunities available at theirstore. For example, FIG. 3A illustrates a clinical opportunities searchscreen 300 including a button 310 available in the top menu bar to allowthe users to access the clinical opportunity search screen. This button310 may be added between the patient search and doctor search buttons.In sample embodiments, the user may search clinical opportunities basedon the following criteria:

Program Type

Opportunity Type

Status

The search will display opportunities for the store housing the pharmacymanagement system that match the search criteria. The opportunities forthat store may be filtered. For example, all immunizations available forthat store may be identified. For each opportunity, the following dataelements may be displayed:

Opportunity Description

Patient Name

Last Payor

User Action Taken Flag

Last User to Take Action

Time of Last User Action Taken

Etc.

In a sample embodiment, the clinical opportunities may be launched fromthe clinical opportunity search screen. A ‘view details’ button may beadded to the search screen. A user will be able to select an opportunitydisplayed in the search result by selecting a ‘view opportunity’ buttonor by double-clicking the opportunity to launch the Clinical Opportunityscreen. When the user launches the Clinical Opportunity screen from thesearch results, only the selected opportunity may be displayed. If theuser launches the screen from the search results screen and chooses tocreate a script for the selected opportunity, then the user will firsthave to select the order in which the script needs to be added.

In sample embodiments, the search screen may include a location columnthat shows the store location, a due date column, a ‘My Store’ checkboxthat may be checked to show the store's current opportunities, anopportunity notes section, and a drop down box that lists opportunitynotes to select from. The search screen also may have editable text anda timestamp of the note written. Activity documented on the searchscreen by any user will not result in the action status of theopportunity moving to pending or closed status.

The clinical opportunities screen 320 illustrated in FIG. 3B may bedisplayed during the dispensing workflow of the pharmacy managementsystem if the selected patient has available opportunities. After a userhas selected a medication, the clinical opportunities screen 320 may beautomatically launched over the order wizard. At this point in thedispensing flow, only opportunities 330 that are in a “New” status willbe displayed. When the user opens a prescription in product reviewstatus, then the clinical opportunities screen will be automaticallylaunched over the order wizard. At this point in the dispensing flow,any opportunities that are in pending, unacted upon by the technician,or configured only to the pharmacist will be displayed. However, ifthere are high priority notes for the current prescription, then thehigh priority notes must display before the clinical opportunity screenis displayed. The auto-launch of the opportunity screen may beconfigurable.

In sample embodiments, a clinical opportunity may be suppressed duringdispensing flow if a prescription being dispensed is to address thatopportunity. Suppression types may be configured for a program or anopportunity. As noted above, available suppression types may includevaccine, service, NDC, and GCSN. The suppression value should be of thesame type as the suppression type setting on the program for theopportunity. For example, if the suppression type for the immunizationprogram is set to vaccine and the suppression value for an immunizationopportunity is set to ‘FLU’, then this opportunity will not be displayedwhile dispensing a prescription for a flu vaccine.

The rules for suppressing an opportunity depend on suppression type andsuppression value. For example, suppression type “Vaccine” suppressesthe opportunity for all prescriptions where the NDC is for a particularvaccine. Similarly, suppression type “Service” suppresses theopportunity for all prescriptions where the NDC is for a particularservice, the suppression type “NDC” suppresses the opportunity if theprescription being dispensed is for the particular NDC, and thesuppression type “GCSN” suppresses the opportunity if the prescriptionbeing dispensed is for the particular GCSN.

In sample embodiments, a dedicated button is added on the MedicationHistory screen of the pharmacy management system for use in launchingthe Clinical Opportunities screen for the patient. For example, asillustrated in FIG. 4 , the Medication History screen 400 may bemodified to include a new “View Opportunities” button 410. This buttonwill be enabled only if there are opportunities for the selectedpatient. If the user launches the screen from the Medication Historyscreen and chooses to create a prescription for the selectedopportunity, then the user may first have to select the order in whichthe prescription needs to be added.

The Clinical Opportunities screen may also be launched from the OrderSummary screen in the pharmacy management system by adding a dedicatedbutton on the Order Summary screen to launch the Clinical Opportunitiesscreen for the patient. As illustrated in FIG. 5 , the Order Summaryscreen 500 may be modified to include a new “View Opportunities” button510.

If the user chooses to create a prescription for the selectedopportunity, then the prescription is added to the current order. Allopportunities are either New, Pending, Closed, Deleted, or Removed asoutlined below. New or Pending opportunities are available for users totake action upon whenever they are displayed.

New

An opportunity is considered new when an action has not been performedyet. “New” is the state of any new opportunity that is created for apatient. If an opportunity was previously in Pending status and has hadall of the actions taken on it undone by either a technician or apharmacist, then the opportunity may become “New” again.

Pending

An opportunity is considered “Pending” when an action has been performedby a technician but not yet reviewed by a pharmacist.

Closed

An opportunity is considered “Closed” when a pharmacist has taken anaction or reviewed an action taken by a technician.

Deleted

An opportunity is considered “Deleted” if it was in a Pending state butit does not come back in the subsequent search because it is no longervalid for the patient.

Removed

An opportunity is considered “Removed” if it was in a “New” state but itdoes not come back in the subsequent search because is no longer validfor the patient.

The pharmacy management system is adapted to control how opportunitiesfor a patient are displayed to the user on the Clinical Opportunitiesscreen. For example, the number of opportunities displayed at one timeis limited. In sample embodiments, a configuration flag determines themaximum number of opportunities to be displayed during the dispensingflow. When a pharmacist is opening the Clinical Opportunities screen anda technician has responded to opportunities for the patient, then thoseopportunities will always be displayed to the pharmacist at productreview. Additionally, the pharmacist may be shown new opportunities ifthey are higher priority than those that the technician responded to(e.g. new opportunities arrived via daily feed since the technician lastworked the prescription).

On the other hand, opportunities will not be displayed when theprescription being dispensed does not belong to the current store. Forexample, during shared data entry at a helping store, no patientopportunities will be presented. Also, opportunities may not bedisplayed when product review is done for a spoke prescription at thehub or at the central fill facility.

Opportunities that are closed, deleted and removed will not be displayedon the Clinical Opportunities screen.

If Clinical Opportunities are displayed for a patient during thedispensing flow once for each touch point (i.e., at select medicationand product review) in a store, opportunities will no longer beauto-launched for that patient in that store for rest of that day forthe same touch point. In other words, the same opportunities do not keeppopping up on the Clinical Opportunities screen.

When configuration data is missing, the opportunities/actions will notdisplay. In sample embodiments, the following data elements must bedefined in order for opportunities to be displayed in the pharmacymanagement system:

Program name;

Opportunity name; and

At least one allowed action in the program configuration table (RXCPC)for the program ID to which the opportunity belongs. Of the allowedactions defined, only those which also have the action text defined maybe displayed. Since an action text is a required field when creating anaction, if none of the configured allowed actions have an action textdefined, then the opportunity may not be displayed at all.

By design, if the above configuration data is missing, then anopportunity or action may not be displayed. However, as long as theprogram and/or opportunity descriptions are present in the definitiontables, the program/opportunities will appear in the ClinicalOpportunity search dropdown menus.

To determine whether an action was taken from the search or workflowfunction and what opportunities were presented from the workflow, thelist of opportunities shown to the user in the dispensing workflow maybe captured to allow reporting to be performed. The opportunities may bedisplayed for an action to be taken. The data from such an audit may beforwarded to the opportunity system and/or stored in the pharmacymanagement system mainframe.

The user is allowed to perform actions on available ClinicalOpportunities for a patient. For example, the table below listsrepresentative actions that a user may take in order to respond to anopportunity, along with the corresponding event that would be triggeredin in the pharmacy management system. The list of actions available andthe action display text for a particular opportunity may be configuredthrough the portal application.

Action ID (Used Proposed Programs for Action Configured Display Displayto Display Order) Text System Action When Performed Action  100 Start RxLaunch the Order Wizard to create Immunization a new prescription forthe patient. If the Clinical Opportunity screen was launched during thedispensing flow or from Order Summary, the new script will be created inthe same order and will open in the background to be completed after thecurrent prescription. If the screen was launched from Medication Historyor the Opportunity Search screen, the user will have to select an orderor create a new order before the script can be created. Once theprescription is created, an Rx Note will be automatically added to itstating that the script was created as a result of a clinicalopportunity, along with the opportunity description.  200 Create Launchthe Task Wizard to allow All Programs patient the user to add a remindertask. follow-up The user will have to choose the task appropriate taskcategory. The following data will be pre- populated: 1. Category:Clinical Opportunity; 2. Description: <Opportunity Description>; 3.Action required: Press F9 to view patient profile. Contact SSCUSTVIEW$$at $$CUSTPHN$$ and discuss the recommended vaccine (Prevnar 13).\n\nDocument outcome as appropriate (i.e., Start Rx, Log Self-ReportedImmunization). Discuss clinical opportunity and educate as needed\n4.Document clinical opportunity outcome as appropriate (New Rx, Servicestab, MTM platform)”; 4. Priority: High, Medium, or Low as specified inopportunity configuration; 5. Start By: Current time plus number of daysspecified in opportunity configuration (default is current time); 6. Dueby: Start By time + 1 week; 7. Expires on: 11:59pm on Due By date.  300Patient No system action occurs when the Immunization not user selectsthis choice. MTM interested Predictive Refill  400 Log self- Launch theService Wizard to allow Immunization reported the user to document theservice. service The service type and specific service will bepre-populated (e.g. “Immunization” and “Influenza” will both bepre-populated).  500 Enroll Launch Customer Wizard with the Predictivepatient in Demographics tab selected. Refill refill service  600 PrintPoint The action will result in Point of Performance of Care Carepaperwork being printed Measurement paperwork for the patient. If theClinical Opportunity screen was launched during the dispensing flow, thepaperwork will be printed when the prescription is post-finalized. Inall other scenarios, the paperwork will be printed immediately.  700Print Launch the Print Forms screen. If Not form(s) a form name isspecified in the Configured opportunity configuration, then that formwill be pre-selected from the “report type” dropdown.  800 Patient AnOrder Note will be added to Immunization un- the order (dispensing flowonly) MTM available with the title “Clinical Opportunity” Predictive anddescription “Monaco Bag Index Card for Opportunity Refill Descriptions” 900 Log in to No system action occurs MTM platform when the user usingselects this choice. ‘portal links.’ 1000 Defer to No system actionoccurs Immunization pharmacist when the user Performance selects thischoice. Measurement Predictive Refill Note: The above table lists theproposed action display text and it can be changed as desired.

All allowed actions for a program may be sorted in the pharmacymanagement system based on their Action IDs. Lower action IDs may belocated at the top of the screen. Action IDs are not re-used/recycledonce they have been issued. The initial Action IDs in the table abovehave been spaced by intervals of 100 to allow adding new actions in anyorder.

During the dispensing flow, at least one action must be completed on atleast one available opportunity that is presented before the screen canbe closed. This requirement is configurable. Outside of the dispensingflow, the user may cancel out of the screen without performing anyaction.

A button may be present next to each action that when clicked, willperform the action. An action cannot be performed a second time unlessit is first undone by the user. The same button that is used to performan action may be used to undo the action after it has been performed.Undo can only be performed as long as the opportunity has not beenclosed. A user can undo any action that they themselves have performed.

A pharmacist can undo an action performed by a technician. Except for apharmacist being able to undo an action taken by a technician, a usercannot undo an action taken by another user. To the user, undoing anaction may simply be a visual indicator. Any systematic result of theaction, such as creating a new prescription, new task, etc. may beundone by the user in addition to undoing the action on this screen.When an action is undone, a note may be displayed at the bottom of thescreen explaining this to the user. As soon as any other action isperformed again, the note may be hidden.

If a technician performs an action during the dispensing flow and laterwishes to undo the action, the Clinical Opportunities screen may beopened for the patient outside of the dispensing flow to undo the actionas long as the opportunity has not been closed. A pharmacist may undotheir own action before the Clinical Opportunities screen is closed.Once the screen is closed, the action is final and the opportunity isplaced in a closed state. If all actions are undone by either atechnician or pharmacist, then the opportunity will become New again.

In sample embodiments, transactions by the pharmacy management systemare immediately updated to the pharmacy management system mainframe. Atintervals (e.g. 30 minutes), the pharmacy management mainframesynchronizes with the respective pharmacy management systems to provideinformation relating to a new customer, opportunities, and the like. Anopportunity that has been acted upon in one store will not be displayedto a user in another store after the synchronization process has movedthe data to all stores where the patient subscribed. If a user opens anopportunity prior to another store's actions synchronizing to theirstore and attempts to perform an action on it, then the pharmacymanagement mainframe will respond with an error indicating that theaction has already been performed at another store and the user mustcancel.

When the user responds to a clinical opportunity by selecting an actionthat results in launching the Add Task Wizard, a new task category isadded so that the user may create an appropriate task related to theclinical opportunity. As illustrated in FIG. 6 , the screen 600 for theAdd Task Wizard may be pre-populated with data 610 based on the clinicalopportunity 620 when launched from the new screen. Similarly, asillustrated in FIG. 7 , the screen 700 for the Add Service Wizard may beprepopulated with data 710 based on the clinical opportunity 720 whenlaunched from the new screen. Every opportunity that allows a task to becreated through one of its allowed actions also has a corresponding taskdescription defined that matches the opportunity ID/description. Thistask description is pre-selected when the Add Task screen launches. Forexample, a new task in the dispensing application of the pharmacymanagement system may be, triggered based OD the selected action.

The ability to turn-off the entire clinical functionality also may beprovided in the pharmacy management system. For example, the ability toturn-off the auto-launch of the clinical opportunity feature in thepharmacy management system may be provided from the Medication Selectpoint, Product Review point, or both. In other words, any pop-upfunctionality for the clinical opportunities may be disabled. Theability to disable the requirement that a user must perform an actionduring the dispensing flow at the Medication Select point, ProductReview point, or both may also be provided.

In sample embodiments, the pharmacy management system mainframe includescorresponding client database tables that are linked by programopportunity ID. The following tables are illustrated in FIG. 8A and FIG.8B, which illustrate the database design for the pharmacy managementsystem mainframe. As illustrated in FIG. 8A and FIG. 8B:

A table RXCPD PGM DEFN assigns a unique ID and name to all programs. Italso contains other attributes of a program such as user level,suppression type, etc.

A table RXCOD_OPP_DEFN assigns a unique ID and name to all opportunitytypes within a program ID, as well as defining other attributes of theopportunity, such as its priority ranking.

A table RXCPC PGM CFG assigns possible types for a program like “allowedactions” or “weblinks.”

A table RXCOC_OPP_CFG holds configuration values at the opportunitylevel. Examples include the form name to pre-populate upon selecting the“Print form(s)” action and the service type to pre-populate uponselecting the “Patient already has received the service” action.

The table PNCOP_PAT_OPP contains all patient-specific opportunityrecords that have been generated by the opportunity system.

The table PNCOA_OPP_ACTN uses a one-to-many relationship to store allavailable user actions and the responses to each for every patient-levelopportunity.

The opportunities are refreshed every day with data from the opportunitysystem. As opportunities reach their expiration date, they will nolonger be sent from the opportunity system and they will be deleted fromthe pharmacy management system database at the store and at themainframe. In accordance with current rules for pharmacy data retention,recorded actions taken will be present on the opportunity system forthree years. The opportunity system may use this data for futurecalculations of opportunity eligibility.

Mainframe-Pharmacy Synchronization

As noted above, the pharmacy management system 112 may be implemented asthe NexGen Pharmacy Management Application implemented by Rite AidCorporation. In sample embodiments, the pharmacy management system 112may synchronize data with the central pharmacy management system 140 viaWide Area Network (WAN) 195. A data synchronization process is used tosynchronize data from the database 165 to the local pharmacy database ofthe pharmacy system 112. Since the local pharmacy database stores a copyof certain data, the synchronization process ensures that the local copyis current and that the local copy matches the master record stored inthe central database 165. The synchronization process may be specific todata used by the pharmacy management system 112 located at the pharmacy110.

Since the local pharmacy database includes only a subset of the datastored centrally, data subscriptions enable the synchronization processto determine which pharmacies 110 care about which data. Tables are usedto map customers/addresses/doctors (“objects”) to one or more pharmacies110. This mapping is called a “subscription” (e.g. “Pharmacy X issubscribed to object A.”). In sample embodiments, the data subscriptionsmay be at a location level or an object level and map data to one ormore pharmacies 110. For example, the subscription data may be stored intables including:

RXCSC—Customer Subscription table

RXCSA—Customer Address Subscription table

RXDSD—Doctor Subscription table

RXVLL—Location Level table

Subscriptions may be added at the time of data extraction or when anonline transaction has occurred that indicates that a pharmacy 110 hasplaced an object in its local database. Examples of such onlinetransactions include specific customer selection, doctor selection,customer medication history inquiry, customer update, doctor update,address update, and the like.

The tables of the database 165 may further include a primarysynchronization table (RXSYN_SYNC_TBL) that may be used by a mainframebatch sync process when a “real-time sync push” fails. A secondarysynchronization table (RXSYT_SYNC_TBL) also may be used that includesrows that are fetched only after there are no rows remaining on theRXSYN_SYNC_TBL. The secondary synchronization table is used by processesthat produce potentially large amounts of table inserts/updates/deletes.Sync XML, is placed on this table and the table updates are bypassed inthe normal batch sync process. RXSYT is used to avoid negative impact onthe normal dispensing type data that needs to synchronize to thepharmacies 110 in a timely manner. Usage of this table also reducessynchronization network traffic.

In sample embodiments, the data synchronization may be based onlocation. The Location Level table RXVLL provides the data locationinformation.

The protocol implemented by the central pharmacy management system 140includes execution of a batch synchronization job at periodic intervals.For example, a batch synchronization job may be executed every thirtyminutes. The batch synchronization job inserts rows into a new primarysynchronization table (RXSYN) where one row is provided per databaseevent per object/pharmacy mapping.

On the other hand, an online synchronization transaction may beinitiated by the client at the pharmacy 110. The transaction may beexecuted at period intervals, such as every thirty minutes. The pharmacy110 acknowledges receipt of rows from prior synchronizationtransactions, and the central pharmacy management system 140 deletesacknowledged rows and returns the rows remaining on RXSYN for thatpharmacy 110. The received rows may be ordered by timestamp. Also, if apharmacy 110 receives a synchronization record that does not make sense(e.g., an update to a row it does not have), the pharmacy 110 may do acomplete refresh on the underlying object.

The batch jobs implemented by the central pharmacy management system 140include processes for data synchronization, data synchronization problemreporting, synchronization of acquisition data, and the like. Forexample, a first job may pull records from a master log starting fromthe previous run of the first job, eliminate log records that representa delete from the system, and process the remaining log records. Insample embodiments, the master log may contain the following fields ordata:

Creator

Table Name

Time Stamp

Change Type (I)insert, (D)delete and (U)update

(U)pdate Type (B)efore and (A)fter

Load data for that table

The synchronization records are inserted into RXSYN. The RXSYN insertsare either based on subscriptions or sent to one or all pharmacies 110.

The synchronization process also may be split into multiple jobs runningin parallel with each job handling a subset of the synchronized tables.Each successive run of the master log extraction schedule is identical;it picks up where the previous job left off.

Data synchronization problem reporting may use RXSYN to holdsynchronization records with rows written by the batch synchronizationprocess that fetches and deletes rows during execution ofsynchronization transactions. The synchronized records may be collectedby the pharmacies 110 at the periodic synchronization intervals (e.g.,every thirty minutes). Outdated records may be an indication of apossible problem with pharmacy's synchronization service. A job maycheck RXSYN and submit a report when outdated RXSYN rows are found.

A batch process also may be used to process changes made by anAcquisition Program. A control card may indicate which programs modifieddata, and the data modified by these programs may be excluded from thesynchronization process in accordance with timestamps determined withinthe Acquisition Batch Process.

The central pharmacy management system 140 also may include tables thatindicate the restart point in each batch synchronization program by joband program in accordance with the last recorded timestamp. The tablesare updated with the last transaction timestamp after data is committed.

Data synchronization tables also may be populated from a master logutility that indicates the start and finish of the utility and thestarting and ending timestamp processed during that time. A furthertable may contain the total number of Insert, Delete and Updatestatements for each table obtained from the utility.

On the client (pharmacy) side, the protocol may include asynchronization service on a server in the pharmacy 110 that sendsrequests to the central pharmacy management system 140 to receive syncrecords from RXSYN. The service may be restarted daily at the pharmacy110. At startup, the service determines sleep time adjusted by loadbalancer logic of the central pharmacy management system 140 so thateach pharmacy 110 does not contact the central pharmacy managementsystem at the same time. After sleep time, the service creates a syncrequest to send to the central pharmacy management system 140. Therequest may include acknowledgements of previous sync records receivedand processed from the central pharmacy management system 140. Thecentral pharmacy management system 140 deletes acknowledged rows andreturns the rows remaining on RXSYN for that pharmacy in a syncresponse. The rows are ordered by timestamp. The service also deletessent entries that have been acknowledged. The service also applies allother updates by updating underlying database data and adds a record ofeach update to a table of acknowledgments of previous sync records.

Lifecycle of an Opportunity

FIG. 9 illustrates a lifecycle 900 of an opportunity in sampleembodiments. As illustrated, the opportunity system, such as a pharmacyanalytics systems such as a data warehouse system provided by 1010Data,evaluates pharmacy data to identify opportunities at 905. The identifiedopportunity is forwarded to the pharmacy management system mainframe asa New opportunity 910. If not received in the next daily feed from theopportunity system, the New opportunity may become Deleted.

The New opportunity is evaluated at 915 to determine if at least oneaction is performed. If so, it is determined at 920 whether the user isa registered pharmacist. If no action is performed, the process returnsto 910 to process a New opportunity. If the user is a registeredpharmacist, the process is Closed at 925. If the user is determined at920 to not be a registered pharmacist, the opportunity moves to aPending state at 930. If not received in the next daily feed from theopportunity system, the Pending opportunity may become Removed at 935.

The Pending opportunity is evaluated at 940 to determine if at least oneaction is performed. If so, it is determined at 945 whether the user isa registered pharmacist. If no action is performed, the process returnsto 930 to process a Pending opportunity. If the user is a registeredpharmacist, the process is Closed at 925. Otherwise, the process returnsto 910 to process a New opportunity when received.

It will be appreciated that the systems and method described hereinprovide automatic identification of opportunities that may be presentedin the workflow of the pharmacist and presented at the point of sale.

System Configuration

Techniques described herein may be used with one or more of the computersystems described herein and/or with one or more other systems. Forexample, the various procedures described herein may be implemented withhardware or software, or a combination of both. For example, theprocessor, memory, storage, output device(s), input device(s), and/orcommunication connections discussed below can each be at least a portionof one or more hardware components. Dedicated hardware logic componentscan be constructed to implement at least a portion of one or more of thetechniques described herein. For example, and without limitation, suchhardware logic components may include Field-programmable Gate Arrays(FPGAs), Program-specific Integrated Circuits (ASICs), Program-specificStandard Products (ASSPs), System-on-a-chip systems (SOCs), ComplexProgrammable Logic Devices (CPLDs), etc. Applications that may includethe apparatus and systems of various aspects can broadly include avariety of electronic and computer systems. Techniques may beimplemented using two or more specific interconnected hardware modulesor devices with related control and data signals that can becommunicated between and through the modules, or as portions of anapplication-specific integrated circuit. Additionally, the techniquesdescribed herein may be implemented by software programs executable by acomputer system. As an example, implementations can include distributedprocessing, component/object distributed processing, and parallelprocessing. Moreover, virtual computer system processing can beconstructed to implement one or more of the techniques or functionality,as described herein.

FIG. 10 illustrates a block diagram of an example of a machine 1000 uponwhich one or more embodiments may be implemented. In alternativeembodiments, the machine 1000 may operate as a standalone device or maybe connected (e.g., networked) to other machines. In a networkeddeployment, the machine 1000 may operate in the capacity of a servermachine, a client machine, or both in server-client networkenvironments. In an example, the machine 1000 may act as a peer machinein peer-to-peer (P2P) (or other distributed) network environment. Insample embodiments, the machine 1000 may be used in embodiments of thepharmacy management system mainframe as well as the user devices 130 and132, point of sale system 114, and pharmacy system 112 and may be apersonal computer (PC), a tablet PC, a set-top box (STB), a personaldigital assistant (PDA), a mobile telephone, a smart phone, a webappliance, a server, a network router, switch or bridge, or any machinecapable of executing instructions (sequential or otherwise) that specifyactions to be taken by that machine. For example, machine 1000 may serveas a workstation, a front-end server, or a back-end server of acommunication system. Machine 1000 may implement the methods describedherein (e.g., FIGS. 2-7 and 9 ) by running software that includesinstructions that, when processed, implement the methods describedherein. Further, while only a single machine 1000 is illustrated, theterm “machine” shall also be taken to include any collection of machinesthat individually or jointly execute a set (or multiple sets) ofinstructions to perform any one or more of the methodologies discussedherein, such as cloud computing, software as a service (SaaS), othercomputer cluster configurations.

Examples, as described herein, may include, or may operate on,processors, logic, or a number of components, modules, or mechanisms(herein “modules”). Modules are tangible entities (e.g., hardware)capable of performing specified operations and may be configured orarranged in a certain manner. In an example, circuits may be arranged(e.g., internally or with respect to external entities such as othercircuits) in a specified manner as a module. In an example, the whole orpart of one or more computer systems (e.g., a standalone, client orserver computer system) or one or more hardware processors may beconfigured by firmware or software (e.g., instructions, an applicationportion, or an application) as a module that operates to performspecified operations. In an example, the software may reside on amachine readable medium. The software, when executed by the underlyinghardware of the module, causes the hardware to perform the specifiedoperations.

Accordingly, the term “module” is understood to encompass a tangiblehardware and/or software entity, be that an entity that is physicallyconstructed, specifically configured (e.g., hardwired), or temporarily(e.g., transitorily) configured (e.g., programmed) to operate in aspecified manner or to perform part or all of any operation describedherein. Considering examples in which modules are temporarilyconfigured, each of the modules need not be instantiated at any onemoment in time. For example, where the modules comprise ageneral-purpose hardware processor configured using software, thegeneral-purpose hardware processor may be configured as respectivedifferent modules at different times. Software may accordingly configurea hardware processor, for example, to constitute a particular module atone instance of time and to constitute a different module at a differentinstance of time.

Machine (e.g., computer system) 1000 may include a hardware processor1002 (e.g., a central processing unit (CPU), a graphics processing unit(GPU), a hardware processor core, or any combination thereof), a mainmemory 1004 and a static memory 1006, some or all of which maycommunicate with each other via an interlink (e.g., bus) 1008. Themachine 1000 may further include a display unit 1010 (shown as a videodisplay), an alphanumeric input device 1012 (e.g., a keyboard), and auser interface (UI) navigation device 1014 (e.g., a mouse or pen). In anexample, the display unit 1010, input device 1012 and UI navigationdevice 1014 may be a touch screen display. In sample embodiments of themachine 1000, the input device 1012 may include a microphone and/or avideo recorder. The machine 1000 may additionally include a mass storagedevice (e.g., drive unit) 1016, a signal generation device 1018 (e.g., aspeaker), a network interface device 1020, and one or more sensors 1022.Example sensors 1022 include one or more of a global positioning system(GPS) sensor, compass, accelerometer, temperature, light, camera, videocamera, sensors of physical states or positions, pressure sensors,fingerprint sensors, retina scanners, or other sensors. The machine 1000may include an output controller 1024, such as a serial (e.g., universalserial bus (USB), parallel, or other wired or wireless (e.g.,infrared(IR), near field communication (NFC), etc.) connection tocommunicate or control one or more peripheral devices (e.g., a printer,card reader, etc.).

The mass storage device 1016 may include a machine readable medium 1026on which is stored one or more sets of data structures or instructions1028 (e.g., software) embodying or utilized by any one or more of thetechniques or functions described herein. The instructions 1028 may alsoreside, completely or at least partially, within the main memory 1004,within static memory 1006, or within the hardware processor 1002 duringexecution thereof by the machine 1000. In an example, one or anycombination of the hardware processor 1002, the main memory 1004, thestatic memory 1006, or the mass storage device 1016 may constitutemachine readable media.

While the machine readable medium 1026 is illustrated as a singlemedium, the term “machine readable medium” may include a single mediumor multiple media (e.g., a centralized or distributed database, and/orassociated caches and servers) configured to store the one or moreinstructions 1028. The term “machine readable medium” may include anymedium that is capable of storing, encoding, or carrying instructionsfor execution by the machine 1000 and that cause the machine 1000 toperform any one or more of the techniques of the present disclosure, orthat is capable of storing, encoding or carrying data structures used byor associated with such instructions. Non-limiting machine readablemedium examples may include solid-state memories, and optical andmagnetic media. Specific examples of machine readable media may includenon-volatile memory, such as semiconductor memory devices (e.g.,Electrically Programmable Read-Only Memory (EPROM), ElectricallyErasable Programmable Read-Only Memory (EEPROM)) and flash memorydevices; magnetic disks, such as internal hard disks and removabledisks; magneto-optical disks; Random Access Memory (RAM); Solid StateDrives (SSD); and CD-ROM and DVD-ROM disks. In some examples, machinereadable media may include non-transitory machine-readable media. Insome examples, machine readable media may include machine readable mediathat is not a transitory propagating signal.

The instructions 1028 may further be transmitted or received overcommunications network 1032 using a transmission medium via the networkinterface device 1020. The machine 1000 may communicate with one or moreother machines utilizing any one of several transfer protocols (e.g.,frame relay, internet protocol (IP), transmission control protocol(TCP), user datagram protocol (UDP), hypertext transfer protocol (HTTP),etc.). Example communication networks may include a local area network(LAN), a wide area network (WAN), a packet data network (e.g., theInternet), mobile telephone networks (e.g., cellular networks), PlainOld Telephone (POTS) networks, and wireless data networks (e.g.,Institute of Electrical and Electronics Engineers (IEEE) 802.11 familyof standards known as Wi-Fi®), IEEE 802.15.4 family of standards, a LongTerm Evolution (LTE) family of standards, a Universal MobileTelecommunications System (UMTS) family of standards, peer-to-peer (P2P)networks, among others. In an example, the network interface device 1020may include one or more physical jacks (e.g., Ethernet, coaxial, orphone jacks) or one or more antennas to connect to the communicationsnetwork 1032. In an example, the network interface device 1020 mayinclude a plurality of antennas to wirelessly communicate using at leastone of single-input multiple-output (SIMO), multiple-inputmultiple-output (MIMO), or multiple-input single-output (MISO)techniques. In some examples, the network interface device 1020 maywirelessly communicate using Multiple User MIMO techniques.

EXAMPLES

In addition to the clinical services system, the examples include:

Example 1 is a method of providing clinical services comprising:analyzing pharmacy data to generate clinical opportunities for patients;providing a file containing the clinical opportunities to a centralpharmacy management system; the central pharmacy management systemdistributing clinical opportunities to pharmacy management systems inrespective pharmacies based on customers registered with each respectivepharmacy; and presenting clinical opportunities for a customer duringinteractions with the customer in a prescription workflow when fillingprescriptions using a pharmacy management system.

Example 2 is a method as in Example 1 further comprising a Point of Sale(POS) system in the pharmacy at which the customer is registeredpresenting clinical opportunities for the customer when concluding asale for a prescription.

Example 3 is a method as in any preceding example wherein the clinicalopportunities include at least one of an immunization, medicationtherapy management, performance measurement, and predictive refill.

Example 4 is a method as in any preceding example further comprisingproviding a configuration portal that enables a user to add and toconfigure clinical opportunities and actions associated with thegenerated clinical opportunities.

Example 5 is a method as in any preceding example further comprising theconfiguration portal enabling the user to search for clinical programsincluding clinical opportunities based on a program description for theclinical programs and a designated user level.

Example 6 is a method as in any preceding example further comprising theconfiguration portal enabling the user to add a new clinical program anda user level.

Example 7 is a method as in any preceding example further comprising theconfiguration portal enabling the user to specify a suppression type fora clinical program, wherein a suppression type for a clinical programsuppresses clinical opportunities for the customer during theprescription workflow.

Example 8 is a method as in any preceding example further comprising theconfiguration portal enabling the user to edit at least a programdescription, a user level, and the suppression type for a clinicalprogram from a clinical program search screen.

Example 9 is a method as in any preceding example further comprising theconfiguration portal enabling the user to create a clinical opportunityand to assign and unassign actions to a clinical opportunity.

Example 10 is a method as in any preceding example further comprisingthe configuration portal enabling the user to assign and unassign weblinks to a clinical opportunity.

Example 11 is a method as in any preceding example further comprisingthe configuration portal enabling the user to add and to edit clinicalopportunities.

Example 12 is a method as in any preceding example further comprisingthe configuration portal enabling the user to search for an actionassociated with one or more clinical programs.

Example 13 is a method as in any preceding example further comprisingthe central pharmacy management system processing the file containingthe clinical opportunities in response to user queries to identifyclinical opportunities at one or more pharmacies at which the customeris registered.

Example 14 is a method as in any preceding example further comprisingthe central pharmacy management system periodically synchronizing newdata from the processed file, actions taken by the pharmacy managementsystem when responding to a clinical opportunity, and configuration dataamong the central pharmacy management system and the pharmacy managementsystem.

Example 15 is a method as in any preceding example further comprisingsynchronizing actions to be taken in response to respective clinicalopportunities between the central pharmacy management system and the oneor more pharmacies at which the customer is registered.

Example 16 is a method as in any preceding example further comprisingde-identifying a clinical opportunity in a list of available clinicalopportunities when a patient has indicated interest in the clinicalopportunity, an action has been taken to address the clinicalopportunity, and a pharmacist has reviewed the action taken.

Example 17 is a method as in any preceding example further comprisinginserting a clinical opportunities screen into the prescription workflowwhen filling prescriptions using the pharmacy management system andproviding a search interface that enables a user to search for availableclinical opportunities and to launch a selected clinical opportunity toperform identified activities.

Example 18 is a method as in any preceding example further comprisinginserting a clinical opportunities screen into a checkout process at thePOS system that presents available opportunities for a patient duringthe checkout process.

Example 19 is a method as in any preceding example wherein presentingclinical opportunities for a customer during interactions with thecustomer in a prescription workflow when filling prescriptions using apharmacy management system in a pharmacy at which the customer isregistered comprises presenting a clinical opportunities screen to adisplay, the clinical opportunities screen being configurable on thedisplay based on priorities of the clinical opportunities.

Example 20 is a method as in any preceding example further comprisingadding a “Patient not interested” button to a clinical opportunity onthe clinical opportunities screen when a patient has indicated nointerest in the clinical opportunity.

Example 21 is a method as in any preceding example wherein presentingthe clinical opportunities screen comprises presenting a button that,upon selection, allows a user to access a clinical opportunity searchscreen.

Example 22 is a method as in any preceding example further comprisinglaunching a clinical opportunity from search results on the clinicalopportunity search screen.

Example 23 is a method as in any preceding example further comprisingautomatically launching the clinical opportunities screen after a userhas selected a medication using the pharmacy management system or whenthe user opens a prescription in a product review status.

Example 24 is a method as in any preceding example further comprisingsuppressing a clinical opportunity during the prescription workflow whena prescription being dispensed addresses the clinical opportunity.

Example 25 is a method as in any preceding example further comprisingadding a dedicated button on a medication history screen of the pharmacymanagement system that launches a clinical opportunities screen for thepatient upon selection.

Example 26 is a method as in any preceding example further comprisingadding a dedicated button on an order summary screen of the pharmacymanagement system that launches a clinical opportunities screen for thepatient upon selection.

Example 27 is a method as in any preceding example further comprisingpresenting available clinical opportunities to a user of the pharmacymanagement system when the pharmacy management system is in a productreview status irrespective of whether or not the clinical opportunityalready has been addressed.

Example 28 is a method as in any preceding example further comprisingcapturing a list of clinical opportunities shown to a user of thepharmacy management system in the prescription workflow and preparing areport including the list of clinical opportunities.

Example 29 is a method as in any preceding example further comprisingsuppressing a clinical opportunity at a second pharmacy where thecustomer is registered when the clinical opportunity has been acted uponin the pharmacy at which the customer is registered.

Example 30 is a method as in any preceding example further comprisingremoving clinical opportunities from the central pharmacy managementsystem as the clinical opportunities reach their expiration dates andmaintaining a record of actions taken with respect to clinicalopportunities.

In the above Detailed Description, various features may be groupedtogether to streamline the disclosure. However, the claims may not setforth every feature disclosed herein as embodiments may feature a subsetof the features. Further, embodiments may include fewer features thanthose disclosed in a particular example. Also, although the subjectmatter has been described in language specific to structural featuresand/or methodological acts, it is to be understood that the subjectmatter defined in the appended claims is not necessarily limited to thespecific embodiments, features, or acts described above. Rather, thespecific embodiments, features, and acts described above are disclosedas example forms of implementing the claims. Thus, the following claimsare hereby incorporated into the Detailed Description, with a claimstanding on its own as a separate embodiment.

What is claimed is:
 1. A clinical services system comprising: anopportunity system that analyzes pharmacy data to generate clinicalopportunities for a customer and generates a file containing theclinical opportunities for the customer, wherein the clinicalopportunities include clinical services for which the customer has metdefined circumstances for the clinical services; a central pharmacymanagement system that receives the file containing the clinicalopportunities for the customer and distributes the clinicalopportunities to pharmacy management systems in respective pharmacieswhere the customer has registered to receive at least one of a clinicalservice or a prescription; and a pharmacy management system in apharmacy at which the customer has registered, the pharmacy managementsystem implementing a prescription workflow to fill prescriptions andpresenting clinical opportunities for the customer during interactionswith the customer in the prescription workflow.
 2. The system as inclaim 1, further comprising a Point of Sale (POS) system in the pharmacyat which the customer has registered, the POS system presenting clinicalopportunities for the customer when concluding a sale for aprescription.
 3. The system as in claim 2, wherein the POS systeminserts a clinical opportunities screen into a checkout process thatpresents available opportunities for the customer during the checkoutprocess.
 4. The system as in claim 1, wherein the clinical opportunitiesinclude at least one of an immunization, medication therapy management,performance measurement, or predictive refill of a prescription.
 5. Thesystem as in claim 1, further comprising a configuration portal thatenables a user to add and to configure clinical opportunities andactions associated with the generated clinical opportunities.
 6. Thesystem as in claim 5, wherein the configuration portal enables the userto search for clinical programs including clinical opportunities basedon a program description for the clinical programs and a designated userlevel.
 7. The system as in claim 6, wherein the configuration portalenables the user to add a new clinical program and a user level.
 8. Thesystem as in claim 6, wherein the configuration portal enables the userto specify a suppression type for a clinical program, wherein asuppression type for a clinical program suppresses clinicalopportunities for the customer during the prescription workflow.
 9. Thesystem as in claim 8, wherein the configuration portal provides aclinical program search screen and enables the user to edit at least aprogram description, a user level, and the suppression type for aclinical program from the clinical program search screen.
 10. The systemas in claim 6, wherein the configuration portal enables the user tosearch for an action associated with one or more clinical programs. 11.The system as in claim 5, wherein the configuration portal enables theuser to create a clinical opportunity and to assign and unassign actionsto a clinical opportunity.
 12. The system as in claim 5, wherein theconfiguration portal enables the user to assign and unassign web linksto a clinical opportunity.
 13. The system as in claim 5, wherein theconfiguration portal enables the user to add and to edit clinicalopportunities.
 14. The system as in claim 1, wherein the centralpharmacy management system processes the file containing the clinicalopportunities in response to user queries to identify clinicalopportunities at one or more pharmacies at which the customer hasregistered.
 15. The system as in claim 14, wherein the central pharmacymanagement system periodically synchronizes new data from the processedfile, actions taken by the pharmacy management system when responding toa clinical opportunity, and configuration data among the centralpharmacy management system and the pharmacy management system.
 16. Thesystem as in claim 15, wherein the central pharmacy management systemsynchronizes actions to be taken in response to respective clinicalopportunities between the central pharmacy management system and the oneor more pharmacies at which the customer has registered.
 17. The systemas in claim 16, wherein the pharmacy management system de-identifies aclinical opportunity in a list of available clinical opportunities whenthe customer has indicated interest in the clinical opportunity, anaction has been taken to address the clinical opportunity, and apharmacist has reviewed the action taken.
 18. The system as in claim 1,wherein the pharmacy management system inserts a clinical opportunitiesscreen into the prescription workflow when filling prescriptions andprovides a search interface that enables a user to search for availableclinical opportunities and to launch a selected clinical opportunity toperform identified activities.
 19. The system as in claim 1, wherein thepharmacy management system presents a clinical opportunities screen to adisplay, the clinical opportunities screen being configurable on thedisplay based on priorities of the clinical opportunities.
 20. Thesystem as in claim 19, wherein the pharmacy management system adds a“Patient not interested” button to a clinical opportunity on theclinical opportunities screen when the customer has indicated nointerest in the clinical opportunity.
 21. The system as in claim 19,wherein the clinical opportunities screen comprises a button that, uponselection, allows a user to access a clinical opportunity search screen.22. The system as in claim 21, wherein the clinical opportunity searchscreen includes means for launching a clinical opportunity from searchresults on the clinical opportunity search screen.
 23. The system as inclaim 19, wherein the pharmacy management system automatically launchesthe clinical opportunities screen after a user has selected a medicationor when the user opens a prescription in a product review status. 24.The system as in claim 1, wherein the pharmacy management systemsuppresses a clinical opportunity during the prescription workflow whena prescription being dispensed addresses the clinical opportunity. 25.The system as in claim 1, wherein the pharmacy management systemcomprises a dedicated button on a medication history screen thatlaunches a clinical opportunities screen for the customer uponselection.
 26. The system as in claim 1, wherein the pharmacy managementsystem comprises a dedicated button on an order summary screen thatlaunches a clinical opportunities screen for the customer uponselection.
 27. The system as in claim 1, wherein the pharmacy managementsystem presents available clinical opportunities to a user of thepharmacy management system when the pharmacy management system is in aproduct review status irrespective of whether or not the clinicalopportunity already has been addressed.
 28. The system as in claim 1,wherein the pharmacy management system comprises captures a list ofclinical opportunities shown to a user of the pharmacy management systemin the prescription workflow and prepares a report including the list ofclinical opportunities.
 29. The system as in claim 1, wherein thecentral pharmacy management system suppresses a clinical opportunity ata second pharmacy where the customer is registered when the clinicalopportunity has been acted upon in the pharmacy at which the customer isregistered.
 30. The system as in claim 1, wherein the central pharmacymanagement system removes clinical opportunities as the clinicalopportunities reach their expiration dates and maintains a record ofactions taken with respect to clinical opportunities.